Provider Demographics
NPI:1295074789
Name:SEWELL, JOY DIANNE (MA CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:JOY
Middle Name:DIANNE
Last Name:SEWELL
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:MRS
Other - First Name:DIANNE
Other - Middle Name:
Other - Last Name:SEWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA CCC SLP
Mailing Address - Street 1:117 JACOB PARROT RD
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326-9506
Mailing Address - Country:US
Mailing Address - Phone:419-674-4197
Mailing Address - Fax:
Practice Address - Street 1:117 JACOB PARROT RD
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-9506
Practice Address - Country:US
Practice Address - Phone:419-674-4197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 5818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist